Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy.

PURPOSE: To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy. METHODS: A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions. RESULTS: Children demonstrated better stride length (11-12 cm), hip extension (2°-4°), and swing-phase dorsiflexion (9°-17°) in both braces versus barefoot. Push-off power (0.3 W/kg) and knee extension (5°) were better in ADR-AFOs than in DAFOs. Parent satisfaction and walking activity (742 steps per day, 43 minutes per day) were higher for DAFOs. CONCLUSIONS: ADR-AFOs produce better knee extension and push-off power; DAFOs produce more normal ankle motion, greater parent satisfaction, and walking activity. Both braces provide improvements over barefoot.

Case report: Uncommon maxillary lateral incisor with a type 3 invagination and C-shaped root canal system.

Dental practitioners are often called upon to provide endodontic services for patients in pain. Maxillary lateral incisors may present added concerns when planning endodontic services. Dens invaginatus (DI) Oehlers Type 3 classification is a relatively rare phenomenon that occurs primarily in maxillary lateral incisors. It is important to consider this condition in all maxillary lateral incisors and to be aware that it can be difficult to treat when the invagination extends past the epithelial attachment apparatus. Successful outcome may be severely compromised in these cases and requires interdisciplinary approaches. This case study describes a maxillary lateral incisor with DI Type 3 that was refractory to treatment.

Assessment of a thermoplasticized gutta-percha delivery system to effectively obturate canals with varying preparation dimensions.

The purpose of this study was to measure the ability of a thermoplasticized-injectable (TPI) gutta-percha (GP) delivery system to fill a prepared root canal to working length and replicate intracanal defects (coronal, middle, apical) as a function of root canal preparations with varying lateral dimensions. Three split-tooth models with 0.06 taper and different apical gauge preparations, 0.30 mm (group A), 0.40 mm (group B), and 0.50 mm (group C), were used. Obturations were evaluated using an ordinal scale (0-4) based on how much each intracanal defect was replicated. Coronal and middle defects were completely replicated 100% of the time, regardless of the preparation. However, there was a significant difference (p

A comparison of 5 gutta-percha obturation techniques to replicate canal defects.

OBJECTIVE: The purpose of this study was to compare the ability of five different methods of compaction of thermoplasticized GP to replicate four artificially-created defects in the canal walls of an extracted tooth. One of the instruments tested was the EndoTwinn which was recently introduced to the U.S. market and can be used in both the warm lateral (WLC) and warm vertical compaction (WVC) techniques. STUDY DESIGN: Four artificially-created defects were created in the dentinal walls of a split-tooth model which could be separated after each obturation and the obturation mass removed for visual evaluation. Twenty obturations were evaluated for each of the following techniques: Group 1, WLC without vibration using the EndoTwinn; Group 2, WLC with heat and vibration using the EndoTwinn; Group 3, WVC using the Elements Obturation System (EOS); Group 4, Injectable GP using the EOS; and Group 5, WVC using the EndoTwinn. Kruskal-Wallis statistic was used to determine statistically significant differences, pairwise comparisons were analyzed with the Mann Whitney statistic and a Bonferonni adjustment was made, where indicated. RESULTS: Nonparametric analyses with appropriate Bonferroni adjustments indicated statistically significant results favoring Groups 2 and 4. CONCLUSIONS: The EndoTwinn, in heat and vibration mode, and the EOS resulted in better replication of the defects than the other techniques.